Hormonal changes. After childbirth, women experience a big drop in estrogen and progesterone hormone levels. Thyroid levels can also drop, which leads to fatigue and depression. These rapid hormonal changes—along with the changes in blood pressure, immune system functioning, and metabolism that new mothers experience—may trigger postpartum depression.

Physical changes. Giving birth brings numerous physical and emotional changes. You may be dealing with physical pain from the delivery or the difficulty of losing the baby weight, leaving you insecure about your physical and sexual attractiveness.

Stress. The stress of caring for a newborn can also take a toll. New mothers are often sleep deprived. In addition, you may feel overwhelmed and anxious about your ability to properly care for your baby. These adjustments can be particularly difficult if you’re a first-time mother who must get used to an entirely new identity.

Postpartum psychosis is a rare, but extremely serious disorder that can develop after childbirth, characterized by loss of contact with reality. Because of the high risk for suicide or infanticide, hospitalization is usually required to keep the mother and the baby safe.

Postpartum psychosis develops suddenly, usually within the first two weeks after delivery, and sometimes within 48 hours. Symptoms include:

Hallucinations (seeing things that aren’t real or hearing voices)

Delusions (paranoid and irrational beliefs)

Extreme agitation and anxiety

Suicidal thoughts or actions

Confusion and disorientation

Rapid mood swings

Bizarre behavior

Inability or refusal to eat or sleep

Thoughts of harming or killing your baby

Human beings are social. Positive social contact relieves stress faster and more efficiently than any other means of stress reduction. Historically and from an evolutionary perspective, new mothers received help from those around them when caring for themselves and their infants after childbirth. In today’s world, new mothers often find themselves alone, exhausted and lonely for supportive adult contact. Here are some ideas for connecting to others:

Make your relationships a priority. When you’re feeling depressed and vulnerable, it’s more important than ever to stay connected to family and friends—even if you’d rather be alone. Isolating yourself will only make your situation feel even bleaker, so make your adult relationships a priority. Let your loved ones know what you need and how you’d like to be supported.

Don’t keep your feelings to yourself. In addition to the practical help your friends and family can provide, they can also serve as a much-needed emotional outlet. Share what you’re experiencing—the good, the bad, and the ugly—with at least one other person, preferably face to face. It doesn’t matter who you talk to, so long as that person is willing to listen without judgment and offer reassurance and support.

Be a joiner. Even if you have supportive friends, you may want to consider seeking out other women who are dealing with the same transition into motherhood. It’s very reassuring to hear that other mothers share your worries, insecurities, and feelings. Good places to meet new moms include support groups for new parents or organizations such as Mommy and Me. Ask your pediatrician for other resources in your neighborhood.